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The aim of this study was to investigate emotions and emotion regulation of a downsizing in an industrial company. The sample consisted of persons who had experienced a downsizing but have kept the employment, within a same position or being transferred to another one. Data consisted of two focus group interviews, analysed by an inductive thematic analysis. The results have indicated that emotional reactions changed over time as well the emotional regulation did during the different phases. The groups differed in emotional reaction related to the time of decision regarding the retention of employment. One conclusion is that fast and accurate information during the different phases of a downsizing process may lead to more positive emotional reactions, which in consequence may result in a positive experience of the reduction process as a whole. The confidence in management increased across the time, due to its decisiveness during the process of downsizing.

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, University of Umeå, Sweden.

Jensen, B. R.

Sandfeld, J.

Richter, Hans

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.

Lyskov, Eugene

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.

Crenshaw, Albert

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.

Prolonged computer use, especially if fatigue ensues, is associated with visual and musculoskeletal symptoms. The aim was to determine the time-course of perceived fatigue in the wrist, forearm, shoulder and eyes during a 60-min mouse task (painting rectangles), and whether object size and/or mouse use demands were of influence. Also, we investigated performance (number of rectangles painted), and whether perceived fatigue was paralleled by local muscle fatigue or tissue oxygenation. Ten women performed the task for three conditions (crossover design). At condition 1, rectangles were 45 × 25 mm, square paint cursor size 1.3 × 1.3 mm, and mousepointer movement ratio 1:26. At condition 2, the same cursor size and mousepointer movement ratio was used, but rectangles were smaller. At condition 3, the smaller rectangles were used, but the cursor size was also smaller and mousepointer movement ratio was 1:8. The results showed increased self-reported fatigue over time, with the observed increase greater for the eyes, but no change in physiological responses. Condition 2 resulted in higher performance and increased eye fatigue. Perceived fatigue in the muscles or physiological responses did not differ between conditions. In conclusion, computer work tasks imposing high visual and motor demands, and with high performance, seemed to have an influence on eye fatigue.

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.

The overall aim was to study transgender persons’ experiences of, and reactions upon, attitudes and social norms in relation to their gender identity. Another question that was relevant to answer was how transgender persons are affected by the hetero norm. The method used to collect data was through questionnaires published on the internet. The only requirement to participate was to be a transgender over 18 years old, and when the survey closed, 35 respondents had answered it. The questionnaire consisted of both quantitative and qualitative questions. Collected data were analyzed using descriptive statistics and content analysis.

The results indicate that transgender persons living conditions are largely affected by norms, and that they encounter a considerable amount of negative attitudes due to their gender identity. To "pass" as either man or woman turned out to be something that made it easier for transgender people to evade negative attitudes.

One hope is that this study can provide knowledge to different instances in the community to open up to be more open to critical thinking around norms.

The conclusion was that persons with a transgender identity are affected by societal norms and by heteronormativity. It takes a lot of courage to be able to be one self but everything boils down to how strong a person are and the availability of support and role models in the surrounding society.

BACKGROUND: Socioeconomic status (SES) can greatly affect the clinical outcome of medical problems. We sought to assess the in-hospital mortality of patients with the acute coronary syndrome (ACS) according to their SES.

METHODS: All patients admitted to Tehran Heart Center due to 1(st)-time ACS between March 2004 and August 2011 were assessed. The patients who were illiterate/lowly educated (≤5 years attained education) and were unemployed were considered low-SES patients and those who were employed and had high educational levels (>5 years attained education) were regarded as high-SES patients. Demographic, clinical, paraclinical, and in-hospital medical progress data were recorded. Death during the course of hospitalization was considered the end point, and the impact of SES on in-hospital mortality was evaluated.

CONCLUSIONS: This study found that patients with low SES were at a higher risk of in-hospital mortality due to the ACS. Furthermore, the results suggest the need for increased availability of jobs as well as improved levels of education as preventive measures to curb the unfolding deaths owing to coronary artery syndrome.

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Section of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.

Diverse ethnic groups may differ regarding the risk factors and severity of coronary artery disease (CAD). This study sought to assess the association between ethnicity and CAD risk and severity in six major Iranian ethnic groups.

Methods

In this study, 20,165 documented coronary artery disease patients who underwent coronary angiography at a tertiary referral heart center were recruited. The demographic, laboratory, clinical, and risk factor data of all the patients were retrieved. The Gensini score (an indicator of CAD severity) was calculated for all, and the risk factors and severity of CAD were compared between the ethnical groups, using adjusted standardized residuals, Kruskal–Wallis test, and multivariable regression analysis.

Results

The mean age of the participants (14,131 [70.1%] men and 6034 [29.9%] women) was 60.7 ± 10.8 years. The Fars (8.7%) and Gilak (8.6%) ethnic groups had the highest prevalence of ≥4 simultaneous risk factors. The mean Gensini score was the highest for the Gilaks (77.1 ± 55.9) and the lowest among the Lors (67.5 ± 52.8). The multivariable regression analysis showed that the Gilaks had the worst severity (β 0.056, 95% CI 0.009 to 0.102; P = 0.018), followed by the Torks (β 0.032, 95% CI 0.005 to 0.059; P = 0.020). Meanwhile, the Lors showed the lowest severity (β −0.087, 95% CI −0.146 to −0.027; P = 0.004).

Conclusions

This study found that there was heterogeneity in CAD severity and a diverse distribution in its well-known traditional risk factors among major Iranian ethnic groups.

Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.

Sedentary behavior in children is positively associated with an increased risk of both obesity and insulin resistance. Children spend a considerable portion of their awake time in sedentary behavior; however, the pattern of accumulation is not known. Thus the objective of this study was to describe the patterning of sedentary behavior of children at and away from school.

Design and Methods:

The patterns of sedentary time in a sample of 53 children (28 girls) aged 10-12 years during school-term time were examined. Children wore an accelerometer for 1 week. Total sedentary time, prolonged sequences (bouts) of sedentary time, and frequency of active interruptions to sedentary were examined on school days and weekends and within school time and non-school time on school days.

Results:

The data did not support our hypothesis that children accumulated more sedentary time on school days when compared with weekend days (mean [SD]: 64.4% [5.3] vs. 64.9% [9.0], P = 0.686). However, when comparing school time with non-school time on school days, children accumulated more sedentary time at school (66.8% [7.3] vs. 62.4% [5.2], P < 0.001) and spent more time at school in sustained sedentary sequences, that is, uninterrupted sedentary time for 30 min or more (75.6 min [45.8] vs. 45.0 min [26.8], P < 0.002). The children also recorded less breaks per sedentary hour within school time when compared with non-school time (8.9 h−1 vs. 10.2 h−1, P < 0.001).

Conclusion:

Reducing total sedentary time spent both in and out of school remains an important challenge. Interrupting sedentary time more often in the “working” (school) day could also reap important musculoskeletal and metabolic health rewards for children.

University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.

Aly, Magda

Faculty of Nursing, Suez Canal University, Port-Said, Egypt.

El-Sabour, Mona Abd

Faculty of Nursing, Suez Canal University, Port-Said, Egypt.

Ibrahim, Naglaa

Faculty of Nursing, Suez Canal University, Port-Said, Egypt.

Engström, Maria

University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.

Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.

Meal at school is a part of the school studies and it is important for health, but is also a prerequisite for both learning and enjoyment. The school meal can provide students an opportunity to recover from their studies but sometimes students perceive the meal situation as stressful. It is important that the food environment at school works well for school children, so they do not have to rush during the meal and they can get the opportunity to eat in peace. The purpose of this study was to investigate how students perceive lunch break at school. If they feel they get enough time to eat and how they feel during the meal situation in the school restaurant. The research approach of this study was qualitative and the method of data collection was focus groups. Data were analyzed as a content analysis. The aim of the study were secondary school students in grade 7 and 9, one class from each grade was selected. The study was conducted at a secondary school in a municipality in Sweden with approximately 210 000 inhabitants. The results of the study show that students at secondary school feel they have enough time to eat lunch, but the lunch break is too short. The meal environment in the school restaurant is perceived as very messy and stressful. The meal situation was experienced as more stressful at grade 7 students than 9th grade students. The conclusion was that students need longer lunch break and meal environment is perceived as stressful.

Background: Schizophrenia is a form of psychosis, it is rare but a very serious disease and the lifetime risk of becoming sick is 0.8% in Sweden. People with schizophrenia experience altered perception of reality because of symptoms such as hallucinations and delusions. Many relatives of people with schizophrenia argue that there is a lack of knowledge that leads to distorted view of themselves and the environment. The diagnosis of schizophrenia is based on symptoms, which consequently means that nurses have an important role which should include plenty hospitality, communication and understanding of patients' quality of life.

Aim: The aim of this study is to describe how people with schizophrenia experience their quality of life and to describe the method of selection of the articles included.

Method: The present study has a descriptive design and contains a total of 12 articles with qualitative and quantitative effort. The majority of the articles that have been used has the qualitative approach. Data collection has been conducted via PsycINFO.

Main Results: The diagnosis of schizophrenia contributed to confusion and difficulties to accept their disease. Symptoms and side effects of the medicine were the most conspicuous factors that resulted in the loss. Experiences of stigmatization and rejection by the environment were also a contributing factor for a poorer quality of life. The 12 included articles have mainly used the interviews to reach people's subjective experiences of living with schizophrenia.

Conclusion: Schizophrenia affects people's daily lives and relationships with other people negatively which led to the suffering and poorer quality of life. Knowledge of how people with schizophrenia experience their quality of life is important information for nurses that can lead to greater understanding, better reception, care and treatment.

Background: Human error and deficient non-technical skills (NTSs) among providers of ALS in helicopter emergency medical services (HEMS) is a threat to patient and operational safety. Skills can be improved through simulation-based training and assessment. Objective: To document the current level of simulation-based training and assessment of seven generic NTSs in crew members in the Norwegian HEMS. Methods: A cross-sectional survey, either electronic or paper-based, of all 207 physicians, HEMS crew members (HCMs) and pilots working in the civilian Norwegian HEMS (11 bases), between 8 May and 25 July 2012. Results: The response rate was 82% (n=193). A large proportion of each of the professional groups lacked simulation-based training and assessment of their NTSs. Compared with pilots and HCMs, physicians undergo statistically significantly less frequent simulation-based training and assessment of their NTSs. Fifty out of 82 (61%) physicians were on call for more than 72 consecutive hours on a regular basis. Of these, 79% did not have any training in coping with fatigue. In contrast, 72 out of 73 (99%) pilots and HCMs were on call for more than 3 days in a row. Of these, 54% did not have any training in coping with fatigue. Conclusions: Our study indicates a lack of simulation-based training and assessment. Pilots and HCMs train and are assessed more frequently than physicians. All professional groups are on call for extended hours, but receive limited training in how to cope with fatigue.

Background: Obesity is now a growing problem in the world and as a result, several do gastric bypass surgery for weight loss. It is important that the experiences from a physical, mental and social approach is illuminated to provide a better understanding and to help them to right direction.

Aim: To describe the experience situation of life a one person after doing a gastric bypass surgery from a physical, psychological and social perspective.

Method: A descriptive study of eleven scientific articles.

Results: After a gastric bypass, the people have a more positive attitude towards life according the three perspectives. They experienced that they fit into society and could participate in the social and physical context in a better way than before. Sometime after the surgery, the participants experienced that they were back into the old habits which gave them a worse quality of life. They ment that the operation was a tool but the hard part remained and they expected a challenge, as some managed better than others.

Conclusions: It is important to give people good support, and information to enable them to preserve their new lifestyle. They are making a great mental effort, therefore they are indeed of psychotherapy and guidence to find a suitable copingstrategy to handle different situations.

The purpose of this literature study was to describe education, knowledge and attitudes among nurses regarding oral health care and in which way nurses can promote proper mouth care among patients within palliative care. A descriptive design was the method chosen, with articles obtained via Cinahl and Pubmed (Medline). Twelve articles were found that subsequently formed this study. The results showed that many nurses considered having recieved insufficient mouth care training during their education. Since the level of knowledge among many nurses was lacking it has been shown that both staff and patients within palliative care benefit from education. There were many negative attitudes about mouth care among nurses. Moreover, it was not prioritized enough within palliative care according to nurses. However, they felt that it should be. Different programs and developed tools have shown to facilitate nurses' work. Patient education has also contributed to a better mouth status. The conclusion of the study is that there are flaws in education, knowledge and attitudes about mouth care among nurses. To change this nurses want more education and training. Thus better condition can be created for nurses to promote proper mouth care for patients within palliative care.

Through semi-structured interviews with three women working as care personnel in group or service homes for persons with disabilities, perceptions regarding violence as linked to persons with disabilities is studied from a social-constructionist point of view. The study explores how the roles of actors involved can be associated with notions and interpretations expressed, and with what the interviewees regard as “appropriate” action to handle the situation. The role of the aggressor proved crucial. Gender of the actors was not expressed as important but indications existed pointing to perceived differences. When discussing appropriate action, the interviewees related to both a sense of “duty” and the “right” thing to do from a utilitarian perspective. When involving a colleague, loyalty became relevant. Throughout the study the dimension of power and the complexity of violence is considered and its different understandings depending on context, actors and perspective.

The aim of this study is to investigate how men in the social service in Gävle experience gender biases within the social work profession. We conducted a qualitative research with five male social workers that we interviewed regarding gender biases. The main result ended up under three themes which are client influence and reinforcement; work culture; and lastly the unconscious experience. The conclusion is that male social workers experience gender biases accordingly through three themes.

Title: Integration of unemployed immigrants into the labor market in Gävle

Authors: Ibrahim Adan Issack and Ekaterina Ivanova

The aim of this study was to investigate unemployed immigrant’s description of how they perceive the labor market in Gävle. Qualitative method face-to-face interviews were used to gather data. The results of this study shows that an unemployed immigrant seems to encounter hinders and opportunities in the labor market. The following five issues were described as being most important in influencing immigrants’ employment opportunities in Gävle: Swedish language knowledge, previous education, discrimination, social network and family situation. Ecological system theory and previous research were used to analyze the gathered results.

Background: Health-related infections (HRI) are the most frequent occurring care damages in inpatient care. HRI’s does not only impact the individual patient, but it also creates high costs and causes high levels of stress at the organization, as well as the community level. Nurses’ application of and compliance with evidence-based guidelines regarding basic hygiene routines is the most effective way to prevent HRI. An examination of the various factors that contributes to the lack of compliance with the different guidelines are crucial in order to increase the theoretical and practical knowledge amongst nurses. This automatically leads to the performing of a safer patient care.

Aim: The purpose of this literature study was to identify and describe the various factors that may impact the nurse's compliance with basic hygiene routines in the prevention of healthcare related infections and to describe the data collection methods in the academic literature.

Method: A descriptive literature study with results from 12 scientific articles. The literature research was performed in the databases PubMed and Cinahl. The articles were also reviewed based on their data collection method.

Main results: Several factors contributed to how the nurses followed evidence-based guidelines regarding basic hygiene routines. The accessibility that nurses had to hygiene products was a primary cause. Lack of knowledge, time shortage, and high workload were additional causes as to why the basic hygiene routines were not properly performed. Contrary to this, good colleagues, good communication, and a safe workplace proved to be factors with a positive impact on preventive work. Surveys, observations and combined data collection methods were used in the included scientific articles.

Conclusion: There are several factors that affect nurses compliance with guidelines regarding basic hygiene routines. By creating awareness among nurses regarding these factors, they are given the possibility of improving the preventive work against HRI.

Stroke is an endemic disease, which in Sweden approximately 30 000 persons yearly are taken by and is estimated to cost society around 18 billion Swedish kronor (SEK). Dysphagia (eating difficulty in swallowing) is a common and known disorder in stroke patients. Dysphagia is not a disease itself, but rather a symptom of something underlying for example stroke. Dysphagia can lead to malnutrition and the risk of increased mortality.

Aim: The aim of this literature study was to describe the nurse experience and coping strategies working with cancer ill children and to analyze the included articles data collection method.

Method: A descripted literature study with qualitative approach. Eleven articles were included, nine qualitative, one quantitative and one with a mixed method. The articles were found through the database PubMed and Cinahl between the years 2005 to 2015.

Result: Five main themes were found: The nurse experience of working with cancer ill children, communications difficulties with the children and their families, difficulties about the work, and palliative care and death, the nurse coping strategies of working with cancer ill children. The nurses handled it with different coping strategies such as talking with colleges about their experiences. The nurses also had to take control over their own emotions. The data collection methods the included articles used were; semi-structed-, unstructed-, depth- and focus- groups interviews, surveys. One method, participants were responding to one question.

Conclusion: The nurse in pediatric oncology unit, daily faces seriously ill children. Emotional stress is something that the nurse must manage as he/she often faces difficulties and sad situations. The nurse manages these pressures by making use of different coping strategies. Despite these difficulties, the nurse experiences a lot of happiness and thankfulness in her profession.

The main domain in which eating disorders are defined is medical, whereas socio-cultural perspectives are less common. Because social workers seeks to explain different problems taking societal factors into account, we asked ourselves if social workers have a way of understanding eating disorders, that is different from a medical point of view. Two focus group interviews were conducted; the one composed by social workers with experience of working with eating disorders, and the other by social workers without that experience, which enabled comparisons. The interviews were analyzed using socio-cultural and feminist perspectives. The result showed that the social workers use socio-cultural perspectives in explaining eating disorders. Both groups also emphasized the medical perspective, but the first group where less willing than the other to depart from this perspective. The conclusion were made that the social workers having experience of working with eating disorders are more into the medical discourse than are the ones without this experience.

University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Western Norway University of Applied Sciences, Department of Health Sciences, Haugesund, Norway.

Venepuncture and the insertion of peripheral venous catheters are common tasks in health care, and training in these procedures is included in nursing programmes. Evidence of nursing students’ knowledge and skills in these procedures is limited. The main aim of this study was to assess nursing students’ knowledge and skills when performing venepuncture and inserting peripheral venous catheters. Potential associations between level of knowledge and skills, self-training, self-efficacy, and demographic characteristics were also investigated. The assessment was performed by lecturers at a university college in Sweden using the two previously tested instruments "Assess Venepuncture" and "Assess Peripheral Venous Catheter Insertion". Between 81% and 100% of steps were carried out correctly by the students. The step with the highest rating was "Uses gloves", and lowest rating was "Informs the patients about the possibility of obtaining local anaesthesia". Significant correlations between degree of self-training and correct performance were found in the group of students who registered their self-training. No associations between demographic characteristics and correct performances were found. Assessing that students have achieved adequate levels of knowledge and skills in these procedures at different levels of the nursing education is of importance to prevent complications and support patient safety.

Purpose: Performing venepuncture is one of the most routinely performed invasive procedures in nursing care. The aim of this study was to develop instruments for the assessment of nursing students' knowledge and skills when performing venepuncture and inserting a peripheral venous catheter. Methods: Two instruments were developed using the following steps. 1) Assessment items of importance for the procedures (venepuncture 48 items and peripheral venous catheter 51 items) were collected from focus groups including nurses, lecturers and patients. 2) The number of items was reduced using a method based on the Delphi method. Experts (n=51) reviewed the instruments in two rounds. The revised versions included 31 items for venepuncture and 33 items for peripheral venous catheter insertion. 3) Usability tests were conducted by nurses who tested the instruments to confirm that items were possible to assess. 4) Inter-rater reliability was assessed by twelve lecturers who in pairs, but independently of each other, used the instruments to assess 50 nursing students. Results: Proportion of agreement and Cohen's kappa coefficient were calculated for each item to determine inter-rater reliability. Among the tested items for both instruments, the median proportion of agreement was 1 (range 0.66-1) and the median kappa was 0.52 (range 0.22-1). Conclusions: The instruments developed for assessing nursing students' knowledge and skills of venepuncture and peripheral venous catheter insertion showed satisfactory inter-rater reliability.

The purpose of this study was to investigate whether feedback from the first line manager increase job satisfaction and work motivation for employees. The sample for the study were employees between 18-65 years, and data collection was conducted through a web-based survey which generated 157 completed questionnaires. The survey was based on Feedback Orientation Scale (FOS), Minnesota Satisfaction Questionnaire (MSQ) and Basic Need Satisfaction at Work Scale (BNS). The analyse were performed in SPSS and the result showed a positive correlation between the index of feedback and job satisfaction, but not between the index of feedback and job motivation. The result also showed that positive feedback predicted job satisfaction and job motivation. No differences in estimation of feedback, job satisfaction and work motivation were found between men and women.

The purpose of this quantitative study was to examine if self- perceived intrinsic work motivation differed between men and women and between three age groups (20-38 years vs. 39-50 years vs. 51-65 years). The data was collected by administering the Basic Need Satisfaction at Work Scale (BNS) to employees at an international company. The survey was based on the Self-Determination Theory (SDT) and measured intrinsic work motivation by asking 21 propositions that concerned the sub-categories autonomy, competence and belongingness. The result of this study showed that there was no difference between men and women in self-reported intrinsic work motivation. However, there was a main effect of age group, wherein employees aged between 39 and 50 years reported a lower score on the propositions that measured perceived competence compared to employees aged between 20 and 38 years. This study highlights the importance of that individuals aging can have an influence on the perceived intrinsic work motivation.

Pain is a phenomenon which not only affects patients physically but also mentally. Women who have undergone mastectomy feel that pain affects their quality of life. Mood swings, poor sleep, depression, anxiety and physical impairments are common symptoms that result in postoperative pain. The purpose: The purpose of this study was to illustrate what different treatments and nursing treatments the nurse can give in pain after mastectomy. Method: The study was conducted as a literature study where the authors examined sixteen scientific studies. Results: The results of the study showed that good communication, information, and the nurse's knowledge are vital to be able to provide adequate pain treatment. Concern reinforces the post-operative pain, and through early secures the patients anxiety and depression can be avoided. Concrete treatment methods with good effect on the pain that emerges in this study are individual rehabilitation, PCA pump, and that early outcomes in many cases contributes to a better quality of life. What also emerged in the study was the lack of research into practical treatments, despite high demand.

The objective of this study was to gain insight into how patients with addiction or dependency problems feel that nursing staff behave towards them. The concepts of addiction and dependency cover all forms of addiction to and dependency on narcotics, alcohol and pharmaceuticals. The essay is a descriptive empirical study based on 10 interviews with people addicted to or dependent on drugs. The selection criteria has been 5 men and 5 women aged between 25 and 60 who have been treated at least 5 times at substance abuse inpatient units. The interviews have been analyzed based on the method qualitative content analysis and resulted in two main categories: Kind treatment and Not so kind treatment. The results showed that those people interviewed had both positive and negative experience of how nursing staff behaved towards them. The conclusion, however, is that negative, prejudiced behaviour was predominating. Those people interviewed also felt that there was a large lack of knowledge about the problems of substance abuse and dependency within healthcare and that the younger, recently qualified nursing staff behaved more badly towards them and were more prejudiced than the older and more experienced nursing staff.

The aim of this study is to examine the impact of the social characteristics of the host society on the second generation Iranians’ understanding of their national and ethnic identities. In this regard I have studied how the second generation Iranians in Sweden identify themselves with Iranian society, with the Iranian ethnic group in Sweden and/or with Swedish society and then compared the second generation Iranians in Sweden and those in the Unites States to try to make clear the impact of the host society on the second generation Iranians’ understanding of their ethnic and national identities.

Educational attainment is regarded as a cornerstone in the identity construction of second generation Iranians (Hartman, 2009; Bozorgmehr and Douglas, 2010; Shavarini, 2004). The literatures, which is based mainly on the studies conducted in the Unites States among second generation Iranians, indicates several factors being important for such an attainment. I have examined whether these factors also are important for the second generation Iranians in Sweden; this in order to more concretely show the impact of the social characteristics of the host society on the second generation Iranians' understanding of their identities.

For gathering the data in Sweden I used semi-structured e-mail interviews with fifteen young people of Iranian background (defined as individuals with both parents born in Iran).

When comparing my study with those in the United States, I could not find the identity tensions and identity crisis reported by the research on second generation Iranians in the United States among the same generation in Sweden. The comparison between the two groups concerning the educational attainment strengthens the hypothesis that the social characteristics of the society where the second generation Iranians live in, has an import impact on their understanding of their ethnic identity.

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.

Macassa, Gloria

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.

Larsson, Johan

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.

There is an increased global interest in occupational health across small businesses as they represent a large share of employers in many societies. In the model of healthy work organisations, employee health is a prerequisite for higher productivity and profitability and management practices are considered as determinants of organisational health. A better understanding of how managers in effective companies use their time can offer a better understanding of how this can affect employees’ well-being and business effect-iveness. Managers’ long working hours and share of time spent on Management by Walking Around (MBWA) are considered important characteristics of managers’ work that might have consequences for employees’ and managers’ own health outcomes, as well as for organisational effectiveness. MBWA is a management technique common for successful companies in regard to their effectiveness; providing an opportunity for a spontaneous manager-subordinate interaction that might be important for employee health and wellbeing. Studies of managerial work have to some extent not clearly placed managers’ time use in the broad context of leadership, often missing to link it with leadership behaviour theories, health and effectiveness.

Objective

The objective of this study was to explore, on the one hand, the total amount of working hours that managers spent, and on the other, their patterns of time allocation to different activities in effective SMEs. Research questions were: 1) What patterns regarding managers’ working hours can be identified across socio-demographic variables, leader-ship experience factors and leadership profiles in effective SMEs? 2) What patterns regarding proportions of total working hours spent on MBWA can be identified across socio-demographic variables, leadership experience factors and leadership profiles in effective SMEs?

Method

The study used data collected within the project, “Successful Companies in Gästrikland”. Annually the project nominates 120 companies for the award based on companies’ financial indicators. The study employed a cross-sectional design and analysed responses to questionnaires collected within the project during years 2014-2018. The inclusion criteria were small and medium sized companies (more than four and less than 250 subordinates), high-level managers having subordinates. Data analysis were carried out using descriptive statistics and regression analysis.

Results

The results section is being processed and will be reported on the conference.

36.

Ahmadi, Elena

et al.

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.

Vilhelmson, Pär

University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.

Macassa, Gloria

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.

Larsson, Johan

University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.

This book is based on triangulation research consisting of a sociological qualitative and quantitative study among people struck by cancer and a study conducted among nurses working in cancer care.

The aim of the book is to present the results of these studies, in particular those of the quantitative study.

The qualitative study aimed at identifying the religious and spiritually oriented coping methods used by cancer patients in Sweden, which serves as an example of societies in which religion is not an integrated part of the social life of individuals. The empirical data for the study were based on interviews with cancer patients. Fifty-one interviews were conducted in various parts of Sweden with patients suffering from different types of cancer. Concerning the use of religious and spiritually oriented methods by the Swedish informants, we learn that gaining control over the situation is a very important coping strategy for them. The informants show a strong tendency toward relying primarily on themselves for solving problems related to their disease. Receiving help from other sources, among others God or a supreme power, seems to primarily be a way to gain more power to help oneself, as opposed to passively waiting for a miracle. For the informants, thinking about spiritual matters and spiritual connection seems to be more important than participating in religious rituals and activities. Turning to nature as a sacred and available resource is a coping method that all informants have used, regardless of their outlook on God, their religion and philosophy of life or their age and gender. The qualitative study shows clearly the impact of culture on coping.

The qualitative study on nurses focuses on coping among Swedish oncology nurses. The research questions were close to the coping theory (Pargament, 1997) that was used for interpretation. 1. How can the stress experienced by oncology nurses be described? (Ekedahl & Wengström, 2007) 2. Which functional and dysfunctional coping strategies do nurses use to cope with work-related stress? (Ekedahl & Wengström, 2006) 3. What religious components can be identified as coping resources in oncology nurses’ orienting system and what function does religiosity have in their work? (Ekedahl & Wengström, 2010) 4. How does culture influence the coping process through different coping styles? (Ekedahl, 2011; Ekedahl & Wengström, 2012)

Four levels of stress were identified: the individual level of the nurse, a group level that is related to the team, an organizational level, and a cultural level. Nurses working in cancer care have to cope with different types of stress. They move from simpler types to the worst type of stress: multifaceted stress with an existential dimension. The most intensive stress is on the individual level and the group level, where the existential dimension is activated.

Concerning the coping strategies, the dominant one is boundary demarcation. Lack of this important strategy is dysfunctional. Religious coping is dominated by basic trust and prayer and can provide support. Using concepts from cultural psychology, individualistic and collectivistic coping are suggested as additional coping styles.

The aim of the quantitative study was to examine the extent to which the results obtained in the qualitative study among cancer patients, explained above, are applicable to a wider population of cancer patients in Sweden. In addition to questions relating to the former qualitative study, this survey also makes use of the RCOPE questionnaire (designed by Kenneth I Pargament) in designing the quantitative study. In this quantitative study, 5000 questionnaires were distributed among persons diagnosed with cancer; 2355 people responded. The results show that nature has been the most important coping method among cancer patients in Sweden.

The highest mean value (2.9) is for the factor ‘nature has been an important resource to you in allowing you to deal with your illnesses.’ Two out of three respondents (68%) affirmed that this method helped them feel significantly better during or after their illness. The second highest average (2.8) is for the factor ‘listening to “natural music” (birdsong and the wind).’ Two out of three respondents (66%) answered that this coping method helped them feel significantly better during their illness. The third highest average (2.7) is for the factor ‘walking or engaging in any activity outdoors gives you a spiritual sense.’ Concerning the role of nature as the most important coping method for cancer patients, this survey confirms the results obtained from the previous qualitative studies.

Moreover, the results of the quantitative study indicate that few informants used religious coping methods, as they were inclined to trust their own abilities to solve problems more than other sources of power, such as God or a religious authority. This result may be partly due to the predominance of secularism in Swedish society and the strong position individualism plays in Swedish culture, which fosters the idea that individuals are responsible for tackling their own problems.

In this chapter, the result of three research studies on meaning-making coping conducted among cancer patients in Sweden is used to highlight the effect of music in coping with cancer. The first research was a qualitative research aiming to study coping with cancer, through religious and spiritual means, from a cultural perspective. The second project was a quantitative study, which aimed to determine to what extent the result of the first study could be generalized to the cancer patients in Sweden. The third study had as its target to investigate the cancer patients’ own understanding of the role of music in coping. The results of these studies indicate the impact of culture in using music as a coping method when facing the psychological burden cancer brings with itself. The outcomes of the third study showed, besides the impact of culture, the individual characteristics of the music as a coping method.

40.

Ahmadi, Fereshteh

University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.

Background: This study investigated patients’ understanding of the role of music in coping and in influencing their well-being.

Methods: A qualitative study was conducted based on semi-structured interviews with 17 cancer patients. Participants were chosen from a group of patients who had listened to or played music as a means of coping with their illness.

Results: The study shows the importance of considering the roles that different kinds of music play in coping with cancer. The music of nature, healing music, religious music and cheerful music each have different benefits for patients.

Conclusions: A patient’s situation and his or her individual characteristics determine the types of that music can act as a useful or harmful coping strategy. Therefore, it is essential to investigate the types of individual characteristics that can make listening to different kinds of music a helpful or harmful coping method.

In order to examine, from a patient perspective, the role music plays as a coping method when facing cancer, I conducted a qualitative study based on semi-structured interviews with 17 cancer patients. The patients were between 24–73 years of age and had used music (listened to or played music) to cope with their illness. In this article, four case studies serve to highlight one of the major findings: that the lyrics of religious, cheerful, and hard and heavy music can help cancer patients obtain a balance in their inner feelings by identifying themselves with the person to whom the song lyrics are addressed. This result may be of interest to therapists using music therapy interventions, especially with patients suffering from serious illness.

This book provides an alternative, complementary approach to the existing conventional approaches to religious and spiritually oriented coping. By focusing on the role of culture, the authors take into account the methods employed by a vast number of people who do not directly identify themselves as religious. The empirical data used in this book derive from studies conducted in several countries; Sweden, China, South Korea, Turkey and Malaysia, across which religion plays a different role in the social and cultural life of individuals. This approach and these empirical data are unique and allow comparisons to be made between different cultural settings.

By introducing the concept of meaning-making coping, the authors explore the influence of culture on choice of coping methods, be they purely religious, spiritual or existential. The term "existential meaning-making coping" is used to describe coping methods that are related to existential questions; these methods include religious, spiritual and existential coping methods.

Meaning-making Methods for Coping with Serious Illness contributes to new approaches and theoretical models of coping. As such it is an invaluable resource for health care, medical, public health and sociology students and researchers. It will also be of interest to educators and policy-makers working in the area of health.

46.

Ahmadi, Fereshteh

et al.

University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.

Ahmadi, Nader

University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.

The authors have conducted a quantitative survey to examine the extent to which the results obtained in a qualitative study among cancer patients in Sweden (Ahmadi, Culture, religion and spirituality in coping: The example of cancer patients in Sweden, Uppsala, Acta Universitatis Upsaliensis, 2006) are applicable to a wider population of cancer patients in this country. In addition to questions relating to the former qualitative study, this survey also references the RCOPE questionnaire (designed by Kenneth I Pargament) in the design of the new quantitative study. In this study, questionnaires were distributed among persons diagnosed with cancer; 2,355 people responded. The results show that nature has been the most important coping method among cancer patients in Sweden. The highest mean value (2.9) is the factor ‘nature has been an important resource to you so that you could deal with your illnesses’. Two out of three respondents (68 %) affirm that this method helped them feel significantly better during or after illness. The second highest average (2.8) is the factor ‘listening to ‘natural music’ (birdsong and the wind)’. Two out of three respondents (66 %) answered that this coping method significantly helped them feel better during illness. The third highest average (2.7) is the factor ‘to walk or engage in any activity outdoors gives you a spiritual sense’. This survey concerning the role of nature as the most important coping method for cancer patients confirms the result obtained from the previous qualitative studies.

To understand the role of culture on the use of the meaning-making coping among people who have been struck by cancer, qualitative and quantitative studies have been conducted in several countries like Sweden, China, Japan, South Korea, Malaysia, Philippines, and Turkey. This article reports on a quantitative study carried out in Turkey. The aim of the study has been to answer the following question: “Which meaning-making coping method (even nonreligious or spiritual coping methods) is used by informants?” The sample consists of 95 persons, 18+ who had been struck by cancer. The questionnaire was distributed to former/current cancer patients via a web address as an electronic survey through the media page of Cancer Survivors Association. The results of the study show that the most important coping methods used by cancer patients in Turkey are the religious coping (RCOPE) methods, particularly spiritual connection, active religious surrender, passive religious deferral, and pleading for direct intercession. Several RCOPE methods such as spiritual discontent, seeking support from clergy or members, punishing God reappraisal, and demonic reappraisal or self-directing religious coping are not used by the Turkish informants. Nor are non-RCOPE methods highly prevalent among informants.

The aim of this article is to elucidate and discuss the results of the 2016 Diversity Barometer (Mångfaldsbarometern) and compare these results with those obtained from ten years of the longitudinal Diversity Barometers for 2005?2014. An additional aim is to demonstrate whether and how Swedish people?s experiences of and attitudes toward people with a foreign background and ethnic diversity have changed.A random sample of the Swedish population took part in the annual study, which was carried out in the form of a nationwide postal survey. The results show that negative attitudes toward ethnic and cultural diversity in general, and migrant population in particular, have increased to some extent and with respect to certain issues. Views on diversity in relation to culture and religion ? especially Islam ? were more negative than views on diversity in relation to work. Those who have larger experience of contact with foreigners show a more positive attitude toward diversity compared with those with limited experience and contact. Individuals who have higher education, those who identify themselves as female, younger persons and those living in large cities are more positive than other groups. In our analysis of the empirical data, we proceeded from a social work perspective and applied contact theory and group conflict theories relating attitudes to group position.

The purpose of the present project has been to carry out international studies on meaning-making coping among people who have been affected by cancer in a number of societies and, thereby, to try to understand the influence of culture on use of these coping methods. Five countries—Sweden, South Korea, China, Japan, and Turkey—are included in the project. Qualitative semistructured interviews have been conducted with persons with a cancer diagnosis. The research group in each country has used, as a foundation, the interview questions developed for the Swedish study. These questions were, however, modified to better suite the sociocultural context of each participating country. The results presented here concern only Turkey and are restricted to religious coping methods. The study consists of 25 cancer patients (18 females and 7 males) between 20 and 71 years of age. The results of the study in Turkey indicated that the RCOPE (Religious Coping) methods are highly relevant for the interviewees. A sociological analysis of the study made from a cultural perspective showed clearly the importance of the idea of being tolerant (Sabr) for patients when coping with the psychological problems brought about by cancer. The study made it clear that culture plays an essential role in the choice of coping methods.